# KLUTH FAMILY DENTISTRY,INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003356973
- **Authorized official:** MS. SANDY LYNN FISHER (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (317) 770-1050

## Contact information

- **Practice address:** 16000 PROSPERITY DR STE 400, NOBLESVILLE, IN 46060-4322
- **Practice address phone:** (317) 770-1050
- **Practice address fax:** (317) 770-1645
- **Mailing address:** 16000 PROSPERITY DR STE 400, NOBLESVILLE, IN 46060-4322
- **Mailing address phone:** (317) 770-1050
- **Mailing address fax:** (317) 770-1645

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12009126 | IN | Yes |

## Other

- **Enumeration date:** 02/27/2017
- **Last updated:** 03/21/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100173090A | — | IN |